Rheumatoid arthritis, a condition that is frequently referred to as “RA” in clinical studies, is a form of inflammatory immune disease that is responsible for causing discomfort in the joints. If you suffer from rheumatoid arthritis, then your immune system may struggle to tell the difference between healthy and unhealthy cells, leading it to attack the tissues in your joints. The result of this attack is inflammation, which can cause stiff joints, swelling, and pain.
Although there is currently no cure for rheumatoid arthritis, treatments have been found to be effective when it comes to slowing the progression of the disease, as well as minimizing the damage that can be done to joints, and in relieving symptoms. One key to successful treatment is recognizing the most common symptoms, which aren’t always as straight forward as you might imagine. In fact, one of the most common symptoms of rheumatoid arthritis is dry eye.
Eye Complications and Rheumatoid Arthritis
Although the main symptoms associated with rheumatoid arthritis are generally swelling, pain, and stiffness around the joints, the inflammation associated with rheumatoid arthritis and a misfiring immune system can lead to various other problems. For example, RA can lead to heart conditions, lung disease, neuropathy, a higher risk of osteoporosis, and even eye problems – most commonly dry eye.
Research has increasingly proven that inflammation can lead to damage in unexpected places, as well as in unexpected ways. Unfortunately, the eyes are not at all immune to the pain of rheumatoid arthritis. The main component of connective tissue, which is collagen, can be impacted by rheumatoid arthritis, leading to discomfort in the cornea and sclera, which are made up almost entirely of collagen.
According to current research, up to 25 percent of patients who suffer from rheumatoid arthritis will experience some kind of eye-related problem. The most common of which are pain, dryness, grittiness in the eyes, and also blurred vision.
Can Eye Problems Point to Rheumatoid Arthritis?
Some people who know about the connection that exists between dry eye and rheumatoid arthritis wonder whether dry eye could point to the existence of RA. In fact, many doctors advise patients to undergo tests for autoimmune diseases if they are suffering from dry eye problems, red eyes, or other common symptoms. However, it’s important to note that dry eyes do not necessarily ensure a person will suffer from rheumatoid arthritis. The causes of dry eye are often wide ranging, and chances are that your condition could be caused by a variety of other factors.
However, if you are suffering with problems of dry eye connected with other symptoms of RA, such as flu-like symptoms or incredibly painful joints, it is important to speak to your doctor about your concerns. If you have any pain, dryness, itchiness, or redness in your eyes, regardless of various other symptoms, be sure to visit your doctor for tests and diagnosis.
Although there are a wide range of complications that can occur as a result of rheumatoid arthritis, the most common eye related complaint with people suffering from RA is ongoing dryness. The medical term for this condition is known as keratoconjunctivitis sicca, and the issue occurs in anywhere up to a quarter of all patients with RA. According to research, the condition occurs as a result of deformities that take place within the tear ducts as a reaction to an abnormal immune system.
If you do experience dry eyes, either as a result of rheumatoid arthritis, or simply in response to another condition, then chances are that you will experience a number of symptoms. Usually, the signs of dry eyes become more significant during the latter part of the day, as the tears from the ducts generally dry up and evaporate over time. Symptoms might include:
• A burning sensation in the eyes
• Redness around the eyes or in the whites of the eyes
• Blurred or obstructed vision
• A feeling of grittiness in the eyes
• Excessive eye watering
If your eyes become particularly red as a result of the dryness, or in addition to dry eye symptoms, this could be a sign that you are suffering from something known as scleritis. This condition takes place when the sclera, otherwise known as the white part of the eye, starts to become inflamed. Keep in mind that redness caused by scleritis cannot be treated through the use of artificial tears or eye drops.
Uveitis and Sjogren’s Syndrome
Another common complication of rheumatoid arthritis is a condition known as uveitis. Usually, this condition will only occur during the earliest stages of the disease. Uveitis often occurs when the uvea, the layer that is located between the white of the eye and the retina, becomes inflamed. Symptoms may include pain, light sensitivity, redness, and blurry vision.
If you suffer from dry eyes as a result of rheumatoid arthritis, it is also important to ensure that the dry eye symptoms are not a sign of a more complex issue known as Sjogren’s syndrome. Sjogren’s syndrome is a form of autoimmune disorder that can develop alongside other autoimmune diseases like RA. This disease impacts all of the moisture-producing glands in the body, which means that patients often experience itchy and dry eyes, as well as feelings of grit behind the eye lids. Of course, dry eyes are not the only symptom of Sjogren’s syndrome, and this disease can also result in other conditions, such as:
• Dry mouth
• Difficulty speaking and swallowing
• Sores in the mouth
• Cracked, dry skin
• Swollen glands and joints
Further Eye Complications
The eye-related complications that occur as a result of rheumatoid arthritis can lead to additional complications, particularly involving damage to the cornea, which is the clear layer that exists at the very front of the eye. Scleritis, dry eye, uveitis, and Sjogren’s disease can all cause the cornea to become ulcerated, scarred, or scratched if they are not quickly and effectively treated.
This is one of the many reasons why doctors suggest that individuals who suffer with rheumatoid arthritis alongside eye symptoms should seek out treatment and medical care as quickly as possible. Keep in mind that damage to the cornea can sometimes lead to a permanent loss of vision.
Rheumatoid Arthritis and Medication Complications
In some circumstances, the medications that are used for the treatment of rheumatoid arthritis can cause complications that relate to discomfort in the eye. People who are on these medications can sometimes take steps to prevent or minimize their risk level. One drug which can lead to problems is known as prednisone – and consumption of this medication by mouth can sometimes be linked to glaucoma.
In order to avoid complications, chronic users of prednisone should have pressure tests conducted on their eyes at least once a year. This is a standard procedure that can generally be done at any optometrist office.
Another drug that can sometimes lead to eye problems is hydroxychloroquine. Though this drug is rare for rheumatoid arthritis sufferers, it can be associated to damage of the retina, which is responsible for converting light coming into the eye into signals that allow the brain to see.
Treatment for Rheumatoid Arthritis Eye Complications
While there are many possible eye complications that can be associated with rheumatoid arthritis it’s worth noting that many of the issues can be controlled and managed quite effectively with the use of proper treatment. When it comes to getting the right treatment for these conditions, early detection is essential, as well as maintaining a healthy course of treatment for the arthritis symptoms themselves. If you find the correct medications to manage your rheumatoid arthritis, then your chances of experiencing eye disorders and other complications is likely to be significantly reduced.
In addition to other RA medications, your doctor may be able to help you treat various eye symptoms. For example, eye drops and artificial tears can sometimes be effective in relieving dryness. What’s more, corticosteroids are often helpful in reducing itching and redness, while battling the issues associated with deeper inflammation.
Resources and References:
6 Ways Arthritis Can Affect Your Eyes – Different ways in which rheumatoid arthritis can affect the eyes. (Arthritis Foundation)
Rheumatoid arthritis – General information about rheumatoid arthritis and how it impacts the eyes. (Mayo Clinic)
8 Signs and Symptoms of Rheumatoid Arthritis – Symptoms of rheumatoid arthritis. (Health.com)
Dry eye syndrome – Causes – Information about the causes of dry eye syndrome. (NHS.uk)